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NUR 2016: TRAUMA TEST 1 QUESTIONS WITH CORRECT ANSWERS, Exams of Nursing

NUR 2016: TRAUMA TEST 1 QUESTIONS WITH CORRECT ANSWERS

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NUR 2016: TRAUMA TEST 1 QUESTIONS WITH CORRECT
ANSWERS
1) What is hyperthermia? -- Answer โœ”โœ” Core body temperature greater than 39.4
degrees C
2) What is the pathophysiology of hyperthermia? -- Answer โœ”โœ” Body is producing
more heat than it can dissipate due to loss of internal cooling mechanisms and/or
inability to sweat
3) What are the signs and symptoms of hyperthermia? -- Answer โœ”โœ” Nausea, vomiting,
flushed and dry skin, confusion, irritability, possible loss of consciousness
4) Who is at most risk for hyperthermia? -- Answer โœ”โœ” Very young, very old, obese,
or critically ill
5) What is the treatment for hyperthermia? -- Answer โœ”โœ” Remove them from the
heat, bring down core temperature, monitor vital signs.
6) How to cool a patient down? -- Answer โœ”โœ” Cool IV fluids, ice chips, cold wash rags,
turn on AC
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NUR 2016: TRAUMA TEST 1 QUESTIONS WITH CORRECT

ANSWERS

  1. What is hyperthermia? -- Answer โœ”โœ” Core body temperature greater than 39. degrees C
  2. What is the pathophysiology of hyperthermia? -- Answer โœ”โœ” Body is producing more heat than it can dissipate due to loss of internal cooling mechanisms and/or inability to sweat
  3. What are the signs and symptoms of hyperthermia? -- Answer โœ”โœ” Nausea, vomiting, flushed and dry skin, confusion, irritability, possible loss of consciousness
  4. Who is at most risk for hyperthermia? -- Answer โœ”โœ” Very young, very old, obese, or critically ill
  5. What is the treatment for hyperthermia? -- Answer โœ”โœ” Remove them from the heat, bring down core temperature, monitor vital signs.
  6. How to cool a patient down? -- Answer โœ”โœ” Cool IV fluids, ice chips, cold wash rags, turn on AC
  1. Why is it so important to monitor vital signs while cooling a patient? -- Answer โœ”โœ” If a patient is cooled too quickly, they may have dysrhythmias or sudden changes in blood pressure due to vasoconstriction
  2. What patient teaching is required for hyperthermia? -- Answer โœ”โœ” Hydration, avoid outside environment during high temperatures, prevention is key
  3. What is the treatment for snake bites? -- Answer โœ”โœ” Antivenom ideally within 4- 12 hours after the initial bite, possible support ventilation, monitoring for at least 12 hours (cardiac and neuro)
  4. How should an extremity be positioned after a snake bite? -- Answer โœ”โœ” Keep it immobilized and below the level of the heart.
  5. What labs should be monitored after a snake bite? -- Answer โœ”โœ” Coagulation labs
  6. Why are neuro assessments so important after a snake bite? -- Answer โœ”โœ” To ensure the venom is not changing their mentation
  7. Who is most at risk for snake and spider bites? -- Answer โœ”โœ” Children ages 1- 9
  8. True or false: You should aspirate the venom out of a snake bite wound. -- Answer โœ”โœ” False
  1. What are the treatments for poisoning? -- Answer โœ”โœ” Antidote, activated charcoal, removal of poison from stomach via NG tube, if there is no antidote then hemodialysis, seizure precautions
  2. True or false: Ipecac syrup is no longer recommended for poisonings due to the stomach contents causing further damage to the esophagus. -- Answer โœ”โœ” True
  3. What is the antidote for Tylenol? -- Answer โœ”โœ” acetylcysteine
  4. What is the START System? -- Answer โœ”โœ” Used to evaluate trauma patients in the field. Assesses respirations, perfusion, and mental status. Depending on the assessment they are classified as green, yellow, red, or black
  5. What is START stand for? -- Answer โœ”โœ” Simple Triage and Rapid Treatment
  6. How does the Simple Triage and Rapid Treatment (START) assessment go? -- Answer โœ”โœ” Is the patient walking? If yes, they are green. Are there respirations? If yes, are they under or over 30? If over 30 they are RED. If under 30 move on to perfusion. If no respirations, position airway. If still no respirations they are dead. If there are respirations with the airway repositioned, the patient is RED. Move on to PERFUSION. If radial pulse is present proceed to assessing mental status. If radial pulse is absent or cap refill is under 2 seconds, move on to assessing mental status. If radial pulse is absent and cap refill is over 2 seconds, control the bleeding! This patient is immediate! MENTAL STATUS. If they can't follow simple commands they are immediate. IF they can follow simple commands they are yellow
  7. What does green mean on Simple Triage and Rapid Treatment (START)? -- Answer โœ”โœ” Patient is walking and talking, has minor injuries. (No treatment)
  1. How long can care be delayed for green patients? -- Answer โœ”โœ” Three hours
  2. What does yellow mean on Simple Triage and Rapid Treatment (START)? -- Answer โœ”โœ” Still breathing and have adequate circulation, can follow simple commands. (DELAY)
  3. How long can care be delayed for yellow patients? -- Answer โœ”โœ” One hour
  4. What does red mean on Simple Triage and Rapid Treatment (START)? -- Answer โœ”โœ” Unresponsive and cannot follow commands. Emergent, requires immediate intervention or else they will die. (Emergent)
  5. What does black mean on Simple Triage and Rapid Treatment (START)? -- Answer โœ”โœ” No breathing or circulation, considered dead, do not waste resources on them. (Deceased)
  6. What are primary explosion injuries? -- Answer โœ”โœ” Injuries resulting from the change in pressure like ruptures, perforations of bowels, pulmonary contusions, hemos/pneumos
  7. What are secondary explosion injuries? -- Answer โœ”โœ” When objects fly through the air and hit the patient
  8. What are tertiary explosion injuries? -- Answer โœ”โœ” When the person is flung through the air and hits something.
  1. What is included in the preparedness phase of disaster? -- Answer โœ”โœ” Mock fire drills and evacuation, evaluates our own weaknesses
  2. What is a crisis standard of care? -- Answer โœ”โœ” Change of normal healthcare standards to give resources and help those with a chance of survival instead of doing the best for everyone
  3. Where is the incident command center typically located within the hospital? -- Answer โœ”โœ” ED
  4. An operations chief, planning chief, logistics chief, finance/admin, public information office, safety officer, and liaison officer are all part of....? -- Answer โœ”โœ” Incident command
  5. What is included in the hospital response (part of disaster response)? -- Answer โœ”โœ” PPE (preservation), decontamination, surge capacity, hospital evacuations, mental health
  6. What are the most common types of trauma in order? -- Answer โœ”โœ” Poisoning (24%), motor vehicle accident (19%), firearms (18%), falls (14%), suffocation (9%), all others (16%)
  7. What age and gender is at highest risk for traumatic injury? -- Answer โœ”โœ” 15 - 24 years old, older than 65, males
  1. True or false: Alcohol is involved in 1/3 of all motor vehicle accidents. -- Answer โœ”โœ” True
  2. What differentiates a level 1 trauma center from a level 2 trauma center? -- Answer โœ”โœ” Level 1 trauma center has 24 hour in house coverage by general surgeons and prompt availability of lots of other specialties.
  3. What commonly causes blunt trauma? -- Answer โœ”โœ” MVC and falls
  4. Which is more life threatening, blunt trauma or penetrating trauma? -- Answer โœ”โœ” Blunt trauma (the extent of injury is less obvious)
  5. What are the causes of blunt trauma? -- Answer โœ”โœ” accelerating, decelerating, shearing, crushing, and/or compression
  6. What is an acceleration injury? -- Answer โœ”โœ” external force contacting the head, suddenly placing the head in motion. Ex. Being hit in the head by a bat or something falling on a person.
  7. What is a deceleration injury? -- Answer โœ”โœ” When the moving head is suddenly stopped or hits a stationary object. Ex. falling and hitting your head
  8. What are shearing injuries? -- Answer โœ”โœ” When adjacent body structures move in opposite directions
  9. What is the most common type of penetrating trauma? -- Answer โœ”โœ” GSW
  1. What should be assessed with airway and c-spine in your primary survey? -- Answer โœ”โœ” Assess for airflow, obstruction, position, simple or advanced airway, stabilize c- spine
  2. If you see an obvious obstruction in the back of someone's throat, what should you do? -- Answer โœ”โœ” Preform a finger sweep
  3. Brain injury will occur as a result of hypoxemia within __ minutes. -- Answer โœ”โœ” 5
  4. What maneuver should be used to open an airway if there is a suspected c-spine injury? -- Answer โœ”โœ” Jaw thrust maneuver (NOT head tilt chin lift)
  5. After opening an airway with either a head tilt chin lift or jaw thrust maneuver, what is the next step? -- Answer โœ”โœ” Place an OPA or some type of advanced airway to maintain patency (Until you can get an advanced airway you can use a BVM)
  6. What is an indication that a patient is not protecting their own airway? -- Answer โœ”โœ” Gurgling or snoring
  7. What should be assessed with breathing in your primary survey? -- Answer โœ”โœ” Rate, rhythm, depth, sounds, chest movement, trachea midline, cyanosis
  8. What should be assessed with circulation in your primary survey? -- Answer โœ”โœ” Blood pressure, pulse, rhythm, quality, active bleeding, shock
  1. If someone needs fluid resuscitation secondary to hemorrhage, what fluids should be used -- Answer โœ”โœ” Isotonic fluids (LR, NS) and/or blood products
  2. What should be assessed with disability in your primary survey? -- Answer โœ”โœ” Level of consciousness/AVPU, motor function (can they follow commands, are they posturing?), super quick neuro
  3. How to quickly assess level of consciousness? -- Answer โœ”โœ” AVPU โ€” alert, verbal (responds to verbal stimulation), pain (responses to pain stimulus), unresponsive
  4. What is assessed with exposure/evacuation in your primary survey? -- Answer โœ”โœ” Get pt trauma naked and visualize all external injuries on the front AND back of patient, fluids/blood products, temperature โ€” avoid hypothermia
  5. Why are trauma bays kept warm? -- Answer โœ”โœ” To prevent hypothermia
  6. True or false: If your patient is hypothermic, their likelihood of hypoxia and acidosis will increase. -- Answer โœ”โœ” True
  7. What is the secondary survey for trauma? -- Answer โœ”โœ” A head to toe that is more in depth than the ABCDE primary survey.
  8. What should be assessed with the head on your secondary survey? -- Answer โœ”โœ” Complete neuro exam, GSC, pupil size and reactivity, inspect and palpate cranium for lacs, fractures, contusions, hemotympanum, CSF leakage, and edema
  1. Are solid organs more likely to rupture or have a laceration? -- Answer โœ”โœ” Have a laceration
  2. What should be assessed for on the pelvis, perineum and genitalia during your secondary survey? -- Answer โœ”โœ” Inspect and palpate pelvis for deformity and stability, inspect for any bleeding or wounds from the vagina or perineum, anus tone and rectal wall integrity
  3. What should be assessed for musculoskeletal during your secondary survey? -- Answer โœ”โœ” Inspection and palpation for any obvious injuries or deformities. Palpate for tenderness, crepitus, or abnormal range of motion. Check all peripheral pulses, cap refill, skin color, and temperature
  4. Besides a physical assessment, what other information should be obtained during a secondary survey (if possible)? -- Answer โœ”โœ” Patient's medical history, allergies, medications, surgeries etc
  5. Trauma deaths that occur within seconds or minutes are usually caused by.... -- Answer โœ”โœ” Massive injuries/lacerations to the brain, brainstem, aorta, cord, heard
  6. Trauma deaths that occur within hours are usually caused by... -- Answer โœ”โœ” Hemorrhages. (Epidural, subdural, hemopneumothorax, pelvic fractures, long bone fractures, abdominal injuries)
  7. Trauma deaths that occur days to weeks after the trauma are usually due to... -- Answer โœ”โœ” Complications like sepsis and MODs
  1. What is the golden hour? -- Answer โœ”โœ” Refers to the first hour after trauma. If a patient can receive care in this hour, their chances of survival increase. (This hour is when 30% of death takes place.)
  2. What is the trauma triad of death? -- Answer โœ”โœ” hypothermia, acidosis, coagulopathy
  3. What is coagulopathy? -- Answer โœ”โœ” A condition in which the blood's ability to clot is impaired
  4. Why is pain management so important for patients who have had chest injuries? -
  • Answer โœ”โœ” So they are able to take big, deep breaths
  1. What is becks triad? -- Answer โœ”โœ” Hypotension, muffled heart sounds, JVD (indicates cardiac tamponade)
  2. How is cardiac tamponade treated? -- Answer โœ”โœ” pericardiocentesis
  3. If someone has an open pneumothorax without a chest tube, what type of dressing should be placed? -- Answer โœ”โœ” Vented dressing that is taped on three sides. This allows the air to go out and not back in.
  4. What are later complications of trauma? -- Answer โœ”โœ” Under nutrition, VTE, sepsis, ARDs, DIC, AKI, SIRS/MODs